Individual
JACOB WAYNE FAULKNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC
Contact information
Practice address
1035 RED BUD RD NE, CALHOUN, GA 30701-6010
(706) 602-7800
Mailing address
PO BOX 1344, COLLEGEDALE, TN 37315-1344
(405) 308-2913
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN217024
GA
Other
Enumeration date
04/06/2016
Last updated
04/06/2016
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